EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. COR 1, LOE C-EO.

Poisoning 115

Poisoning Hyperthermia / Hypothermia Seizures Administration 115

EMDocs

JANUARY 16, 2024

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

PulmCCM

JANUARY 29, 2024

AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. Epinephrine remains the drug of choice during CPR Epinephrine remains the first-line therapy for cardiac arrest due to non-shockable rhythms (i.e.,

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Despite good quality CPR, there is no ROSC. C and remained pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

RebelEM

SEPTEMBER 14, 2023

Did they get bystander CPR? At our institution patients do not go for diagnostic heart catheterization and then get put on ECMO, they are initiated on ECMO during the time of their initial resuscitation and then go for heart catheterization once they are stabilized. bleeding, stroke, limb ischemia, and hemolysis). Zeymer HT et al.

Shock 136

Shock Resuscitation Outcomes Stroke 136

RebelEM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Epub 2023 Jun 15. Epub 2023 Jun 15. Resuscitation. Paper: Eastwood G, et al. N Engl J Med. N Engl J Med. Epub 2021 Feb 8.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

ACEP Now

NOVEMBER 7, 2024

Background From its founding in 1881 to today, the American Red Cross has taught tens of millions of Americans first aid and other lifesaving skills, including CPR. It also offers a comprehensive “CPR for the Professional Rescuer” course. In 2015, it introduced Basic Life Support (BLS) training and certification for EMS personnel.

Advances Cardiac Life Support (ACLS) 74

Advances Cardiac Life Support (ACLS) Military CPR Basic Life Support 74

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. Read in AJRCCM In The News The Hospitalist and the Resuscitationist 2023 Conference will take place September 27-30 in Montreal. makes me long for an adequately powered randomized trial. Patients with secondary pneumothoraces (e.g.,

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

PEMBlog

AUGUST 20, 2024

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. Extracorporeal Cardiopulmonary Resuscitation. Starting an extracorporeal cardiopulmonary resuscitation program: success is in the details.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

The Skeptics' Guide to EM

MARCH 11, 2023

Date: March 8, 2023 Reference: Smida et al. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Date: March 8, 2023 Reference: Smida et al. Case: A paramedic crew responds to a 54-year-old male in cardiac arrest at a private residence.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

Stop and Think

JANUARY 10, 2024

Let’s do two topics on the RCT that I covered in my Top Ten Stories of 2023 piece. One scenario that doctors considered dire enough to use ECLS occurs when CPR does not work to restore circulation. Another RCT-related story from 2023 involved attempts to simulate randomized trials with observational data. odds ratio, 1.4;

CPR 44

CPR Shock Outcomes Resuscitation 44

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Resuscitative attempts were initiated quickly. 3-vessel disease can make resuscitation very difficult, since CPR does not perfuse diseased vessels as well as one would like. At 47 minutes, when the physician returned, the patient was found to be in ventricular fibrillation with agonal breathing.

EKG/ECG 135

EKG/ECG Resuscitation CPR Emergency Department 135

Dr. Smith's ECG Blog

APRIL 30, 2024

Bystander CPR. He was resuscitated into a perfusing rhythm. I refer the interested reader to My Comment in the February 27, 2023 post in Dr. Smith's ECG Blog — in which I review the challenges in determining the cardiac rhythm with hyperkalemia — as well as reviewing the sequence of expected ECG changes with this electrolyte disorder.

EKG/ECG 108

EKG/ECG EMS CPR Resuscitation 108

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. 2023;e2320850.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

AED Leader

DECEMBER 31, 2023

On 16 December 2023, soccer captain Tom Lockyer suffered a cardiac arrest and collapsed during a match at Vitality Stadium in Bournemouth. He received CPR, was fitted with an implantable cardioverter defibrillator in the hospital, and was discharged after five days.

CPR 52

CPR Resuscitation Hospitals 52

AED Leader

DECEMBER 31, 2023

On 16 December 2023, soccer captain Tom Lockyer suffered a cardiac arrest and collapsed during a match at Vitality Stadium in Bournemouth. He received CPR, was fitted with an implantable cardioverter defibrillator in the hospital, and was discharged after five days.

CPR 52

CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Thinking Critical Care

MAY 20, 2023

A message from Katie Wiskar: I cannot express how excited I am to be a part of H&R 2023, and to finally get to experience the magic in person. The Resuscitative TEE Course , run by none other than Felipe Teran is back again! If you’re not personalizing your CPR, here’s the place to learn!

Airway Management 95

Airway Management Resuscitation EKG/ECG CPR 95

Don't Forget the Bubbles

OCTOBER 7, 2024

Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm. Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns. Philadelphia, PA: Elsevier; 2023:chap 130. Resuscitation. In: Walls RM, ed. Culnan, D.M.,

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

JournalFeed

DECEMBER 23, 2023

The JournalFeed podcast for the week of Dec 18-22, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

CPR 52

CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

MAY 20, 2023

Date: May 10, 2023 Reference: Harhay MO, et al. Date: May 10, 2023 Reference: Harhay MO, et al. They started cardiopulmonary resuscitation (CPR) until EMS arrived. Upon arrival at the ED, your team promptly begins high quality CPR and manages to obtain return of spontaneous circulation. NEJM Evidence. N Engl J Med.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Taming the SRU

JULY 2, 2023

Cardiac Arrest As mentioned before, tidal CO2 is a function of metabolic rate and cardiac output, so capnography can be utilized during CPR to monitor the effectiveness of chest compressions. Part 1: executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care."

Emergency Department 88

Emergency Department Pediatrics CPR Resuscitation 88

Don't Forget the Bubbles

MAY 3, 2023

Published 2023 Feb 17. The Pediatric Bougie for the First Tracheal Intubation Attempt in Critically Ill Children [published online ahead of print, 2023 Feb 23]. 2023;S0196-0644(23)00030-6. Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? Resuscitation.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

ACEP Now

AUGUST 15, 2023

Staff interrupt you while you’re in Room 3 with a patient you’ve placed on BiPAP, “We have an incoming patient with CPR in progress in five minutes,” the nurse says before adding, “Room 4’s family really wants to talk with you again.” Accessed July 12, 2023. and, “I hope I make it out on time to tuck my kid into bed tonight.”

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. 2023 Jun 14;49(1):74.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. Recent Clinical Evidence on Post-Arrest TTM The accumulated post-arrest care literature makes clear that careful fever avoidance following resuscitation is essential. Circulation.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Mind The Bleep

OCTOBER 17, 2024

Clinically, your enthusiasm for providing maximal quality care needs balanced against rescue practicalities and a hostile environment (very different to your warm, dry resuscitation bay) – the cold makes all veins disappear…and you may be the only clinician responder at the scene. Each year a team usually reports CPR being delivered.

Soft Tissue Injuries 52

Soft Tissue Injuries Seizures Ambulance Services Teamwork 52

EMDocs

JANUARY 11, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. Cardiac Management Takeaway : Perform an echo as soon as you can to guide resuscitation.

Seizures 97

Seizures Shock Infectious Diseases CPR 97

Taming the SRU

OCTOBER 1, 2023

Common causes include central venous catheterization (subclavian or internal jugular), lung biopsy, barotrauma from PPV, thoracentesis, bronchoscopy, pacemaker insertion, CPR, and intercostal nerve block [12, 14]. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Resuscitation. 10/2/2023

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Intensive Blog

MARCH 13, 2024

Everything ECMO 048: History of ECPR evidence and considerations for future research Author: Dr George Walker Peer reviewer: A/Prof Aidan Burrell Introduction The first recorded attempts to resuscitate patients were as early as 1530 where Swiss physician Paracelsus used fireplace bellows to reinflate the lungs of those who had stopped breathing.

CPR 130

CPR Resuscitation Hospitals Outcomes 130

Don't Forget the Bubbles

DECEMBER 5, 2023

2023 Oct 26;73(736):e850-e857. 2023 Oct 1;177(10):1028-1038. Reviewed by: Vicki Currie Article 5: Does occluding the femoral artery during neonatal CPR increase the likelihood of ROSC? (In Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest.

Resuscitation 111

Resuscitation Outcomes CPR Emergency Department 111

PHARM

NOVEMBER 12, 2024

CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia. From February 2020 to May 2023, over 117 days, the team responded to 709 “potential cardiac arrest” emergency calls.

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) CPR Hospitals Resuscitation 40

Dr. Smith's ECG Blog

MARCH 8, 2025

During the resuscitation, she received amiodarone 450 mg IV, lidocaine 100 mg IV, and magnesium 6 g IV. Angiography was technically challenging as the patient was receiving CPR, but the cardiologist suspected acute stent thrombosis and initiated cangrelor, although no repeat angiography was able to be obtained. link] Jentzer, J.

EKG/ECG 75

EKG/ECG CPR Resuscitation Wellness 75

Don't Forget the Bubbles

JANUARY 6, 2025

Reviewed by: Mikaeel Jaffer Article 2: Does the duration of pre-hospital CPR affect neurological outcomes? Yasuda M, Amagasa S, Kashiura M, et alDuration of prehospital and in-hospital cardiopulmonary resuscitation and neurological outcome in paediatric out-of-hospital cardiac arrestEmergency Medicine Journal 2024;41:742-748.

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59